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Individual

MRS. AMBER INGRAM CHAUNCEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1002 11TH ST SW, LIVE OAK, FL 32064-3606
(386) 364-8050
Mailing address
10660 161ST RD, LIVE OAK, FL 32060-6280
(386) 688-3865

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP3319392
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP3319392
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21213600
FL
Enumeration date
07/18/2005
Last updated
06/09/2022
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